Characteristic findings of perianal lesions in Japanese patients with Crohn's disease.

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We have experienced 63 cases of Crohn's disease over the last 5 years, and 51 of these cases were complicaed by perianal lesions, such as periproctal abscess or anal fistula, anal ulcer or fissure and anal skin tag. Twenty-two affected patients had noticed perianal lesions before suffeing from the gastrointestinal symptoms of Crohn's disease.<BR>The incidence of perianal lesions was highest in patients with colonic Crohn's disease. In particular all patients with rectal Crohn's disease had perianal complications without exception.<BR>The most remarkable features of perianal lesions in Japanese patients with Crohn's disease is that periproctal abscess or anal fistula occurs more frequently than anal ulcers, fissures or skin tags. They tend to have multiple fistulas and their secondary orifice is situated far from their anal margin in comparison with ordinary anal fistula.<BR>Upon rectal mucosal biopsy, epithelioid granuloma was found in only 29% of all patients with perianal lesions, while it was found in 60% of patients with rectal Crohn's disease and 53% with anal ulcer or fissure.<BR>We therefore conclude from these results that careful microscopic and macroscopic observations of perianal lesions are essential for the early diagnosis of Crohn's disease.
日本大腸肛門病学会の論文